DOCTORS,  HYGIENE,  AND 
THERAPEUTICS: 

AX  ANNIVERSARY  DISCOURSE 

DELIVERED  BEFORE  THE  HEW  YORK  ACADEMY  OF 
MEDICINE ; NOVEMBER  18,  1875. 


BY 

E.  DAK  WIN  HUDSON,  Jr.,  A.  B.,  M.  D., 

PROFESSOR  OF  THE  PRINCIPLES  AND  PRACTICE  OF  MEDICINE,  WOMAN’S  MEDICAL  COLLEGE 
OF  THE  NEW  YORK  INFIRMARY ; FELLOW  OF  THE  NEW  YORK  ACADEMY  OF 
MEDICINE  ; MEMBER  OF  THE  MEDICAL  SOCIETY  OF  THE  COUNTY 
OF  NEW  YORK. 


UNA  FIDES  ALTARE  COMMUNE. 


NEW 
D.  APPLETON 

549  & 551 


YOKE: 

AND  COMPANY, 

BROADWAY. 


1876. 


25JetI  N 


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NEW  YORK  ACADEMY  OF  MEDICINE. 


OFFIGEES  FOE  1876. 


President. 

SAMUEL  S.  PURPLE,  M.D. 

Yice- Presidents. 

JOHN  C.  DALTON,  M.  D., 
GOUYERNEUR  M.  SMITH,  M.  D., 
FORDYCE  BARKER,  M.  D. 


Recording  Secretary. 

WILLIAM  T.  WHITE,  M.  D. 


Corresponding  Secretary. 

JOHN  G.  ADAMS,  M.  D. 


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Treasurer. 

JAMES  O.  POND,  M.D. 
Trustees. 

ISAAC  E.  TAYLOR,  M.  D., 
EDMUND  R.  PEASLEE,  M.  D., 
JAMES  L.  BANKS,  M.  D., 
AUSTIN  FLINT,  M.D., 
SAMUEL  T.  HUBBARD,  M.D. 


Librarian. 

JOHN  H.  HINTON,  M.D. 


Assistant  Secretary. 

HORACE  T.  HANKS,  M.D. 


Statistical  Secretary. 

ALLAN  McL.  HAMILTON,  M.D. 


Digitized  by  the  Internet  Archive 
in  2017  with  funding  from 

University  of  Illinois  Urbana-Champaign  Alternates 


https://archive.org/details/doctorshygienethOOhuds 


ANNIVERSARY  ADDRESS. 


Mr.  President  and  Fellows  of  the  Academy  of  Medicine. 

I must  assume  that  the  honor  conferred  upon  me  by 
this  learned  and  honorable  Academy,  in  electing  me  your 
orator,  is  a greeting  from  the  older  members  who  have 
founded  it,  and  advanced  it  to  its  present  position  of  dignity, 
influence,  and  prosperity,  to  the  younger  generation  of  its  Fel- 
lows— to  the  younger  generation  of  physicians — an  assurance 
of  your  interest  in  our  education,  our  growth  in  experience  and 
skill,  our  reputation  and  success  ; that  as  Fellows,  the  older 
and  younger,  though  in  age  rather  as  fathers  and  sons,  are  but 
the  senior  and  junior  members  of  our  honored  and  noble 
brotherhood,  and  that  as  physicians,  we  have  a common  cause, 
a single  interest,  “ Una  fides  altare  commune ,”  the  advance- 
ment in  integrity  and  usefulness  of  the  science  of  medicine. 

The  Academy  of  Medicine,  instituted  in  1847,  to-day  for 
the  first  time  celebrates  its  anniversary  in  its  own  hall,  has  a 
home  of  its  own,  a building  dedicated  to  the  healing  art ; not. 
so  imposing  as  the  Serapeum  at  Alexandria,  or  the  Temples  of 
yEsculapius,  but  an  edifice  adorned,  capacious,  and  inviting. 
May  it  prove  a centralizing,  harmonizing,  organizing  power 
in  our  profession ! The  Royal  College  of  Physicians  first  occu- 
pied the  residence  of  Linacre,  its  founder;  its  now  celebrated 
museum  and  library  started  from  the  gift  of  the  great  Harvey. 
This  mansion  is  the  joint  contribution  of  the  Fellows  of  this 
Academy  ; our  library — a nucleus  of  American  medical  litera- 


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ture,  unique  and  full — is  the  gift  of  its  President.  The  Acad- 
emy is  to  be  congratulated  on  its  present  success.  What  may 
he  its  future  growth  ! What  its  future  influence  for  good,  for 
the  advancement  of  the  profession,  founded,  as  it  is,  upon  wise 
and  lofty  principles  ! HowT  comprehensive  of  the  needs  of  the 
profession  are  the  few,  well-defined  objects  of  this  Academy : 

1.  The  cultivation  and  advancement  of  the  science  of 
medicine. 

2.  The  promotion  of  the  character  and  honor  of  the  pro- 
fession. 

3.  The  elevation  of  the  standard  of  medical  education. 

4.  Public  hygiene. 

The  Academy  imposes  no  limitations  of  constitution  or 
creed,  unduly  conservative  or  violating  the  liberal  and  pro- 
gressive tendencies  of  our  day.  It  was  planned  in  a catholic 
spirit ; it  seeks  the  welfare  of  the  physician,  and  of  the  public 
which  he  guards  and  guides. 

I would  gladly  present,  on  the  occasion  of  this  first  anni- 
versary in  our  new  home,  something  worthy  of  the  time  and 
place.  It  has  been  the  custom  of  the  scholarly  men,  who  in 
the  past  have  filled  this  honorable  position,  to  consider  some 
broad  subject,  instructive  to  the  profession  and  its  friends,  or 
seeking  to  right  abuses  and  correct  popular  misapprehensions 
— subjects  which  their  erudition,  their  age,  and  long  experience 
well  fitted  them  to  discuss.  Lacking  these  qualifications,  I 
feel,  in  the  words  of  Sidney,  that  “ all  is  but  lip- wisdom  which 
wants  experience.” 

But,  “ the  youngest  heart  has  the  same  waves  in  it  as  the 
oldest,  though  without  the  plummet  which  can  measure  their 
depths.” 

Our  profession , as  it  exists  to-day — its  personnel,  its  ethics, 
its  esprit  de  corps  ; its  standing  with  the  learned  and  with 
society,  and  the  resources  with  which  it  practices  to  cure — in 
a word,  our  profession,  its  honest  value  as  a healing  art,  its 
public  influence  ; these  are  questions  of  to-day,  as  of  the  past. 
For  now,  as  then,  our  profession  is  our  alter  ego,  in  which  we 
live,  and  move,  and  have  our  being. 


Dr.  Samuel  Johnson  said  : “A  physician  in  a great  city 
seems  to  be  the  mere  plaything  of  Fortune  ; his  degree  of  repu- 
tation is,  for  the  most  part,  totally  casual ; they  that  employ 
him  know  not  his  excellence,  they  that  reject  him  know  not 
his  deficiency.”  The  same  is  true  to-day.  There  is  the  same 
relation  with  the  public,  who  can  have  no  certain  rule  to  guide 
them  in  discriminating  the  certain  and  scientific  from  the  pre- 
tentious and  false.  Charlatanism  has  its  friends  among  the 
learned  and  cultured — those  who  in  their  own  fields  of  labor, 
and  in  the  affairs  of  the  world,  are  esteemed  judicious  and 
honest.  Even  the  great  Bacon  was  not  averse  to  dabbling  in 
every  specious  and  presuming  mode  of  cure.  “The  impostor 
frequently  triumphs  at  the  bedside  of  tlie  sick  when  true 
merit  is  affronted  and  dishonored.”  In  the  middle  ages,  we 
are  told  by  Hecker,  the  empirics  “ boasted  to  the  inhabit- 
ants of  their  experience  and  skill,  and  with  their  pills  and 
hellish  electuaries  flitted  about  from  place  to  place,  especially 
where  rich  merchants  were  to  be  found,  from  wdiom,  should 
they  be  cured,  they  obtained  the  promise  of  mines  of  gold.” 
In  France,  the  charlatan  is  described  as  an  affair  of  “ pompeux 
galamatias , speoieux  babil , des  mots  pour  des  raisons , et  des 
promesses  pour  des  effetsP  “ A physician,”  wTe  are  told  by 
the  author  of  “ Physic  and  Physicians,”  “ should  never  affect 
ignorance  of  the  cause  of  a complaint.  lie  should  place  it  in 
the  pancreas  or  pineal  gland,  if  he  has  no  other  local  habita- 
tion ready  at  the  moment.” 

A quack  being  asked  how,  without  knowledge,  he  thrived, 
took  his  interrogator  to  the  window,  and  asked,  how  many  of 
a hundred  passers-by  were  wise  ? “ Perhaps  one,”  was  the  reply. 
“ Well,  the  ninety-nine  are  mine.”  What  wondrous  cures  are 
wrought  by  the  charlatan  and  nostrum-vender  in  these  days ! 
What  testimonials  ,do  they  present  from  men  of  business,  esti- 
mable ladies,  and  retired  clergymen,  scarcely  less  ludicrous 
than  the  caricatures  by  Matthews,  in  the  “Flumors  of  a 
Country  Fair!”  “ Sir,  I was  cut  in  two  in  a saw-pit,  and 
cured  by  one  bottle  ; ” “ Sir,  by  the  bursting  of  a powder-mill, 
I wTas  blown  into  ten  thousand  anatomies ; the  first  bottle  of 


8 


your  incomparable  collected  all  the  parts  together,  the  second 
restored  life  and  animation,  before  a third  was  finished  I was 
in  my  usual  state  of  health.”  We  have  to-day  clairvoyant 
doctors,  who,  like  Paracelsus,  think,  since  God  has  not  im- 
parted to  us  the  secrets  of  medicine,  it  is  justifiable  to  consult 
the  devil.  More  fortunate  is  pretension  when  it  assumes  an 
organized  form,  sets  up  a universal  dogma,  asserts  refinement 
in  treatment,  demands  reform.  “ Similia  similibus ” — the 
rust  of  Telephus’s  sword  cured  the  injuries  it  inflicted.  Sir 
Theodore  May  erne  banished  hypochondria  with  the  balsam  of 
bats.  Hudibras  declares — 

“ Wounds  by  wider  wounds  are  healed, 

And  poisons  by  themselves  expelled.” 

Whether  it  be  “a  specious  mode  of  doing  nothing,”  “the 
art  of  amusing  the  patient  while  Nature  cures  the  disease,”  or 
the  vended  and  heroic  nostrum  of  the  day,  all  find  adhe- 
rents. The  wise  and  foolish  alike  follow — 

I 

“Each  proselyte  would  vote  his  doctor  best, 

With  absolute  exclusion  of  the  rest.” 

But  the  real  success  of  charlatans  is  transient.  They 
prosper  for  a brief  period  and  disappear.  Nostrums  are  popu- 
lar and  decline.  Organized  schools  of  theory  and  dogma  have 
had  a brief  existence  in  the  past ; those  of  our  day  will  also 
pass  away.  The  aphorism  of  Hippocrates,  that  “life  is  short, 
but  art  is  long,”  is  prophetic  of  the  perpetuity  of  our  art. 
“ Skepticism  of  medicine,”  says  Mackness,  “has  become  a sort 
of  literary  tradition.”  But  the  sneer  of  Montaigne,  the  satire 
of  Moliere  and  Rousseau,  the  derision  of  Dryden  and  Pope, 
the  caricatures  of  Dickens,  expose  only  our  personal  defects 
and  foibles ; the  rich  and  poor,  the  learned  and  ignorant,  look 
to  us,  with  faith  and  hope,  in  their  hours  of  trouble.  And 
how  true  the  words  of  Byron  for  all  our  adversaries  : 

“ Physicians  mend  or  end  us, 

Secundum  artem — but  though  we  sneer 
In  health,  when  sick,  we  call  them  to  attend  us, 

Without  the  least  propensity  to  jeer.” 


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Yet  what  means  have  the  public  of  judging  between  doc- 
tors of  the  same  or  different  schools  of  practice  ? w7hat  test  of 
the  treatment  they  apply  ? Even  success  is  no  criterion, 
for  the  curative  results  may  have  been  due  to  Nature  rather 
than  remedies,  the  diagnosis  erroneous  or  falsely  made,  ex- 
aggerating the  fleeting  disorder  into  grave  disease.  “ The 
purse  of  the  patient  frequently  protracts  his  cure.”  There 
is  but  one  protection  for  an  ill-informed  and  indiscrimi- 
nating  people — the  presence  in  the  community  of  educated, 
scientific  physicians,  who  have  attained  a high  standard,  pre- 
scribed and  enforced  by  law ; men  wdio,  by  virtue  of  rigid 
mental  discipline  and  thorough  culture,  must  be  believed  to 
possess  personal  integrity,  and  loyalty  to  scientific  truth.  So 
long  as  standards  are  low  or  indefinite,  and  the  entrance  to  the 
profession  has  few  restrictions,  the  choice  of  a doctor  will  be 
an  experiment,  and  human  health  and  life  will  be  at  the  mercy 
of  inexperience,  ignorance,  error,  and  deception.  But  when 
all  physicians  are  men  of  trained  minds  and  high  acquire- 
ments, as  the  public  recognize  that  our  standards  are  high,  con- 
fidence will  strengthen  ; only  regularly-educated  men  will  be 
demanded ; theorists,  empirics,  boasters,  self-announcing  doc- 
tors, will  find  but  a poor  and  shifting  patronag'e. 

The  practical  question  for  our  profession  to-day  is  the 
higher  education  of  the  doctor,  the  only  means  of  combating 
quackery.  We  fail  to  rival  the  adherents  of  charlatanism  in 
mannerism  and  display;  we  must  trust  to  solid  education  of 
the  individual,  scientific  study,  sound  judgment,  superior  cult- 
ure, as  a profession.  We  must  be  actuated  by  honor,  and 
work  with  unity  of  purpose. 

That  too  many  are  wanting  in  the  confidence  and  equipoise 
which  command  esteem,  that  many  have  not  the  power  of 
translating  their  higher  technical  knowledge  into  succinct  and 
intelligible  terms  which  are  lucid  and  convincing,  the  public 
have  frequent  opportunity  to  see.  Witness  the  half-weighed 
statements  of  our  medico-legal  experts,  the  conflicting  testi- 
mony on  insanity.  From  the  disagreements  of  doctors,  pitted 
one  against  the  other,  the  intelligent  layman  must  infer  the 


10 


ignorance  and  avarice  of  the  man,  or  an  unsettled,  indefinite 
state  of  his  art.  Felicity  and  simplicity  of  expression  are  gifts 
of  the  learned  mind  ; they  bear  the  sigillum  simplex  veri — the 
simple  stamp  of  truth.  But  the  medical  profession  has  always 
had  the  strength  of  knowing  its  own  weakness;  even  Hippoc- 
rates, while  praising  his  art,  lamented  the  ignorance  of  those 
who  practised  it. 

And  first,  the  material  with  which  the  profession  of  the 
present  and  future  is  being  reenforced.  Huxley,  an  admirer 
of  its  generous  tendencies  and  comprehensive  field,  has  called 
attention  to  the  numbers  of  the  untrained  and  unscholarly 
who  choose  to  study  the  profession  of  medicine.  Should  not 
the  young  man  be  a man  of  letters,  possessed  of  scientific  tastes 
and  knowledge  ? Should  I16  not  have  the  basis  of  broad,  lib- 
eral education  ? Says  Dr.  John  Brown,  the  author  of  “ Locke 
and  Sydenham  ” and  of  “Bab  and  his  Friends  “ I give  my 
vote  for  going  back  to  the  old,  manly,  intellectual  and  literary 
culture  of  the  days  of  Sydenham,  Arbuthnot,  and  Gregory; 
when  a physician  fed,  enlarged,  and  quickened  his  entire  na- 
ture; when  he  lived  in  the  world  of  letters  as  a freeholder, 
and  reverenced  the  ancients,  while  at  the  same  time  he 
pushed  on  amofig  his  fellows,  and  lived  in  the  present.”  A 
retrospect  of  medicine  will  convince  any  one  that  our  medical 
men  of  letters  have  strengthened  our  profession  in  the  esteem 
of  the  educated  world  ; at  the  same  time  they  have  been  among 
the  contributors  to  its  special  literature.  Celsus,  the  “ Cicero 
of  Medicine,”  Erasmus  Darwin,  Goldsmith,  Keats,  Akenside, 
Arbutlmot,  Sir  James  Clark,  Sir  Henry  Halford,  Abercrom- 
bie, Sir  Charles  Bell,  Faraday — have  they  done  nothing  by 
their  non  professional  writings,  their  beauty  of  diction  and 
general  discourses,  to  honor  their  profession  and  secure  the 
sympathy  and  fellowship  of  men  of  science  and  letters  ? It 
has  been  said  that  medicine  is  the  foster-mother  of  natural  sci- 
ence, and  Dugald  Stewart  regards  it  the  best  preparation  for 
the  study  of  the  mind.  Most  of  the  great  thinkers — Socrates, 
Aristotle,  Locke,  Descartes,  Sir  William  Hamilton — have  con- 
idered  medicine  their  favorite  study.  Surely,  the  latter  be- 


11 


lieved  it  liad  the  true  elements  of  science ; as  defined  by  him- 
self, u a complement  of  cognitions,  having  in  point  of  form  the 
character  of  logical  perfection,  and  in  point  of  matter  the 
character  of  real  truth.” 

Reversely,  what  can  the  physician  profit  by  companion- 
ship with  these  students  of  the  philosophy  and  history  of  mat- 
ter and  mind  ? Is  not  the  doctor  who  has  traced  the  history 
of  the  world’s  mutations,  the  lives  of  nations  and  individuals, 
a better  judge  of  human  character?  . Does  not  his  study  of 
mental  and  moral  philosophy  make  him  a better  alienist,  ena- 
ble him  to  read  the  influence  of  thought  and  emotion  upon  the 
body  in  health  and  disease  ? Surely,  ours  is  a learned  profes- 
sion, though  it  be  a vosation  of  labor,  whose  mastery  exceeds 
the  possibilities  of  any  one  man’s  life,  whose  principles  and 
truths  proclaim  it  a science.  Our  physicians  should,  there- 
fore, have  the  personal  culture  and  scholarly  attainments 
which  would  unite  them  to  all  classes  of  earnest  and  scholarly 
men.  “ The  strength  of  all  sciences  which  consisteth  in  their 
harmony,  each  supporting  the  other,  is  the  strength  of  the  old 
man’s  fagots  in  the  band  ” (Bacon).  Perhaps  in  our  country 
we  have  had  no  one  who  has  filled  the  full  measure  of  the 
learned  and  cultvated  physician  so  completely  as  Dr.  Benjamin 
Push.  He  was  educated  at  home  and  in  Europe.  Returning 
to  Philadelphia,  he  became  eminent,  equally  as  physician,  citi- 
zen, and  scholar.  As  a physician  he  was  a professor  of  medi- 
cine, the  founder  of  the  first  dispensary  of  this  country,  a 
practitioner  of  unequaled  clientage,  and  an  original  investi- 
gator of  disease.  To  his  personal  exertion  and  influence 
not  less  than  six  thousand  of  his  fellow-townsmen  are  esti- 
mated to  owe  their  escape  from  death  by  yellow  fever.  As  a 
citizen,  he  was  a signer  of  the  Declaration  of  Independence, 
he  moulded  the  constitution  and  law  of  his  State,  and  was  in- 
fluential in  establishing  the  common-school  system  of  the 
country.  As  a scholar,  he  was  an  author,  not  only  in  medi- 
cine, but  also  in  literature,  philosophy,  morals,  and  politics. 
He  was  decorated  by  four  sovereigns  of  Europe,  and  elected 
to  learned  societies  at  home  and  abroad.  By  his  genius  and 


worth  he  honored  his  city  and  country,  and  elevated  his  art  in 
the  esteem  of  his  fellow-citizens  and  of  the  sister  professions. 
What  has  been  his  influence  upon  the  medical  profession  of 
his  city  to  give  it  that  element  of  superior  culture  for  which  it 
is  justly  honored  to-day  ! Though  New  York  to-day  is  second 
to  none  in  earnest,  progressive  medical  work,  we  may  well  do 
homage  to  Philadelphia,  whose  faculty  of  medicine  have  done 
so  much  to  maintain  a profession  of  letters.  Her  first  medical 
school  had  Benjamin  Franklin  as  president ; its  professors 
were  Push,  Kuhn — who  had  studied  with  Linnaeus,  Shippen — 
the  student  of  John  Hunter,  Hewson  and  Fothergill,  and  Mor- 
gan— a pupil  of  William  Hunter.  A mantle  of  culture  from 
the  mother-country  had  fallen  upon  the  physicians  of  this  home 
of  Push. 

But  New  York  points  with  pride  to  many  scholarly  physi- 
cians— to  Colden  and  Bard,  to  Beck,  Francis,  Watson,  and 
Draper.  And  New  England  holds  dear  the  names  of  Warren, 
Bigelow,  and  Jackson.  To  William  Tully,  a profound  Ameri- 
can scholar  and  physician,  too  little  known  beyond  New  Eng- 
land, I digress  to  pay  a tribute  of  personal  gratitude  and  justly- 
merited  praise.  William  Tully  was  born  at  Saybrook,  Con- 
necticut, in  1785,  and  died  at  Springfield,  Massachusetts,  in 
1859.  As  a scholar,  he  was  an  accomplished  botanist,  linguist 
and  philologist,  and  a prominent  collaborator  of  Webster’s 
Dictionary.  As  a writer,  he  first  contributed,  with  Dr.  Mirier, 
the  celebrated  “ Essays  on  Fever,”  which  circulated  widely, 
excited  discussion  and  criticism,  and  led  to  the  formation  of  a 
medical  school  of  opinion  having  many  adherents  to-day.  At 
the  time  of  his  death  he  had  prepared  for  the  press  two  vol- 
umes of  “ Materia  Medica  and  Pharmacology.”  They  are 
original  works,  replete  with  the  results  of  extended  and  thor- 
ough personal  observation  and  experiment  as  to  the  physio- 
logical and  therapeutic  action  of  remedials,  especially  of  these 
indigenous  in  America,  as  veratrum  and  conium.  He  advo- 
cated with  zeal  and  power  the  supreme  influence  of  the  gan- 
glionic system  in  the  development  of  symptoms  of  disease  and 
as  the  source  of  indications  for  the  agents  with  which  to  treat 


13 


them.  He  was  president  of  the  Castleton  Medical  School,  and 
for  eleven  years  Professor  of  Materia 'Medica  in  Yale  College. 
He  was  instrumental  in  founding  the  well-known  “ Retreat 
for  the  Insane,”  at  Hartford;  and  in  the  celebration  of  its 
fiftieth  year  of  usefulness,  in  1873,  he  is  justly  styled  “the 
most  learned  man  in  his  special  departments  of  any  in  HeW 
England,  or  perhaps  in  the  United  States.  Prof.  Silliman  has 
pronounced  him  to  have  been  “ one  of  the  most  erudite  and 
philosophical  scholars  in  the  medical  profession.” 

The  impetus  given  to  medical  progress  by  the  pursuit  of 
the  technical  studies  of  our  profession — -the  application  of  the 
microscope  to  anatomy,  physiology,  chemistry,  and  pathology, 
the  methods  of  physical  diagnosis,  the  certainty  of  diagnosis 
and  treatment  in  the  various  specialties — -leave  us  little  to  fear 
for  the  proficiency  and  training  of  the  rising  physicians  to 
render  them  safe  and  successful  practitioners  of  their  art.  But 
I would  enter  a plea  for  a medical  study  not  immediately  es- 
sential to  the  honest  pursuit  of  medicine  as  a livelihood — the 
History  of  Medicine ; with  all  its  details  of  errors,  false  theo- 
ries and  superstition  in  the  past,  it  points  us  back  to  a noble 
lineage  of  heroic  men,  thoughtful  and  earnest  characters,  de- 
voted  and  careful  observers,  worthy  of  our  admiration  and  imi- 
tation. It  will  dissipate  the  imputation  that  medicine  of  past 
times  was  crude  and  loathsome,  and  increase  the  individual 
strength,  dignity,  and  self-respect,  as  being  members  of  an  an- 
cient and  honorable  guild.  We  have  terms  in  our  medical 
nomenclature  to-day  which  take  us  back  to  the  medicine  of 
Alexandria,  of  Greece,  and  Rome,  perpetuating  the  anatomy 
of  Herophilus  and  Galen,  the  surgery  of  Celsus.  How  many 
useful  remedies,  how  many  well-described  diseases,  date  their 
literature  from  the  observing  and  studious  Arabian  school,  the 
Saracen  physicians  and  writers  of  Spain,  who  translated  the 
ancients,  and  saved  their  art  when  Europe  was  immersed  in 
the  darkness  of  the  middle  a^es ! As  with  literature  and  art, 
so  medicine  had  its  period  of  renaissance  in  the  Italian  school 
of  the  fifteenth  and  seventeenth  centuries.  Its  great  names 
are  immortalized  so  long  as  we  study  the  human  frame — 


14 


Vesalius,  Eustachius,  Fallopius,  Fontana,  Casserius,  Vieussens, 
Pacchioni,  Fabricius,  Malpighi.  What  have  been  the  contri- 
butions to  surgery  and  medicine  of  Boerhaave,  Hoffman,  Stahl, 
and  Haller  ; of  Pare,  Bichat,  Sauvage,  Portal ; of  Willis  and 
Winslow,  Harvey  and  Hunter,  Sydenham  and  Huxham  ? But 
the  study  of  medical  history,  the  history  of  medical  discovery 
and  progress,  would  be  rewarded  by  a greater  and  positive 
benefit  to  our  profession  and  the  world.  “It  is  a melancholy 
fact,”  says  Sir  Bichard  Steele,  “verified  by  every  day’s  obser- 
vation, that  the  experience  of  the  past  is  lost  upon  individuals 
and  nations.”  The  established  facts  of  medicine  are  too  often 
ignored,  or  rediscovered  by  the  ill-informed.  A greater  fa- 
miliarity with  its  history,  a knowledge  of  the  origin,  the  source 
of  that  which  is  settled,  is  the  best  point  of  departure  for  fur- 
ther inquiry  and  discovery. 

Hippocrates  practised  incision  and  drainage  of  the  pleural 
cavity,  with  much  success — a procedure  long  abandoned,  but 
being  now  revived. 

Galen  gave  cold  drinks,  with  benefit,  in  fevers,  and  em- 
ployed immersion  ; for  centuries  this  was  overlooked.  Again, 
in  the  beginning  of  this  century,  1805,  Currie  published  a full 
and  complete  manual  of  their  treatment  by  water,  with  details 
and  proofs,  which  were  conclusive,  yet  to-day  we  are  being 
led  again,  by  Ziemssen  and  Liebermeister,  to  a renewal  of  that 
which  should  not  have  been  lost.  De  Haen  methodically 
employed  the  thermometer  during  the  great  fevers  at  Breslau. 
It  was  used  by  John  Hunter.  Currie  employed  the  self-regis- 
tering thermometer  of  M.  Six  in  the  mouth  and  axilla.  It 
was  put  on  record  nearly  one  hundred  and  fifty  years  ago, 
and  but  to-day  is  it  being  utilized.  In  the  sixteenth  century 
the  Italians  found  the  quarantine  and  a stringent  health  code 
the  certain  means  of  limiting  pestilence  and  infection,  yet  how 
long  have  sanitary  corporations  had  full  recognition  and  effi- 
cient value  ! Barker  and  Cheyne,  in  1821,  detailed  the  pavil- 
ion plan  for  hospitals,  with  diagrams  of  the  five  isolated  build- 
ings of  their  fever-hospital.  Sydenham  advocated  fresh  air 
and  cold  water  in  the  treatment  of  small-pox,  and  was  con- 


15 


firmed  by  the  great  fire  of  Pultney,  where  a hundred  and  more 
sick  of  this  malady  were  turned  out,  to  lie  on  beds,  under 
hedges  and  the  arches  of  bridges,  with  an  immunity  from 
deaths  before  unknown.  Yet  scarcely  ten  years  have  we 
had  hospitals  enforcing  these  conditions.  Centuries  ago, 
haemoptysis,  pulmonary  congestion,  and  bronchitis,  were  con- 
ceded predisposing  causes  of  phthisis ; the  certain  relation 
was  recognized  between  squalor  and  privation,  exposure  to 
damp  and  cold,  the  inflammatory  diseases  of  the  respiratory 
apparatus,  and  the  ultimate  development  of  consumption.  For 
a century  this  evident  relation  of  cause  and  effect  has  been  set 
aside  by  the  theory  of  specific  tuberculosis ; but  the  truth 
comes  finally  to  recognition  on  a permanent  basis  of  pathol- 
ogy. In  the  sixteenth  century  Chalin  de  Yinaria  recognized 
the  fatal  error  of  bleeding  in  the  plague  and  in  all  diseases  of 
depressed  vitality.  He  asserted  it  was  safe  only  with  the 
plethoric,  reserving  it,  as  he  humorously  said,  for  the  priests 
and  the  indolent,  whom  it  were  well  to  dispose  of.  Though 
now  discarded,  how  long  did  the  lancet  reign  supreme ! In 
an  age  of  superstition,  amid  the  confusion  of  the  dancing 
mania,  Paracelsus,  the  learned  quack,  presented  a classifica- 
tion of  the  epilepsy,  chorea,  and  hysterical  seizures,  which 
characterized  that  moral  epidemic,  as  rational  as  that  of  neu- 
rologists to-day.  He  distinguished  the  true  from  the  sensuous 
and  imaginative  forms.  Yet  for  centuries  the  victims  of  these 
functional  disorders  were  burned  as  writhes,  or  shunned  by 
society.  There  have  been  great  and  wise  physicians  in  all 
ages  of  medicine. 

Dr.  Benjamin  Push,  in  his  quaint  address  on  “ The  Yices 
and  Yirtues  of  Physicians,”  gives  as  their  fifth  and  last  vice 
66  obstinacy  in  adhering  to  old  and  unsuccessful  modes  of 
practice  in  diseases  which  have  yielded  to  new  remedies.” 
Witness  the  reluctance  fifty  years  ago  to  see  in  physical 
exploration  of  the  chest  a sure  and  definite  guide  to  diagnosis 
of  its  diseases.  But  failure  of  the  average  physician  to  pro- 
gress is  more  often  the  result  of  limited  knowledge.  He  fol- 
lows the  directions  of  the  Faculty,  or  men  whose  teachings 


16 


moulded  him  for  his  life-work.  Asserted  medical  facts,  if  of 
value,  should  not  go  long  untested.  Within  a few  years,  Dr. 
Budd,  of  London,  whom  Sir  Thomas  Watson  has  called  “ one 
of  the  most  strenuous  cultivators  of  our  science,”  has  claimed 
to  control  scarlet-fever  contagion  in  homes  and  asylums,  with- 
out need  of  isolation.  If  true,  it  is  one  of  our  greatest  contri- 
butions to  medicine  of  recent  times,  yet  it  remains  untested 
and  unemployed  ; is  known  to  but  few\ 

Much  is  said,  at  the  present  time,  about  the  u self-limitation 
of  disease,”  “ reliance  upon  Nature,”  “ regimen  and  diet,”  and 
of  the  “ expectant  plan  ” of  treatment.  The  public  sentiment, 
too  often  the  outgrowth  of  the  doubts  and  controversies  of  the 
doctors,  intelligently  recognizes  hygiene , hut  is  skeptical  of 
therapeutics.  An  eminent  physician  is  said  to  have  relin- 
quished practice  because  he  was  tired  of  guessing.  But  these 
imputations  are  unjust.  Mythology  tells  us  that  Hygeia,  the 
goddess  of  health,  was  the  daughter  of  JEsculapius,  the  father 
of  medicine.  Modern  hygiene  is  the  offspring  of  the  physi- 
cian’s devotion  to  the  study  of  the  nature  and  treatment  of 
disease.  Nor  have  our  greatest  therapeutists  ever  ignored  the 
simple  remedies  of  Nature.  The  Greeks  placed  their  temples 
of  the  healing  art  in  the  most  healthful  places  ; purified  the 
air  by  fire  and  odoriferous  incense ; had  baths,  thermal  springs, 
and  gymnasia,  as  adjuvants.  Such  also  were  the  practices  of 
Asclepiades  and  Celsus  in  Borne.  We  point  with  pride  to 
the  school  of  Salerno  and  its  famous  code  of  health.  The 
first  of  Sydenham’s  remedies  was  cool  air,  the  second  diet. 
First,  the  physician  studying  disease,  then  the  detection  of  its 
cause,  and  subsequently  the  measures  for  prevention  and  abate- 
ment— such  is  the  history  of  hygiene.  Had  not  Sir  George 
Baker  known  the  symptoms  of  lead-poison,  he  could  never 
have  traced  the  cause  of  Devonshire  colic — infection  by  lead 
would  have  continued,  insidiously  destroying,  through  the 
channels  of  tinctured  food  and  drink,  and  numberless  unsus- 
pected sources ; and  colic,  paralysis,  and  dementia,  would  have 
claimed  as  victims  those  who  now  are  safe  and  healthy,  Had 
Jenner  been  less  of  a symptomatologist,  less  a student  of  disease, 


17 


less  a physician,  he  would  scarcely  have  pursued  investiga- 
tions whose  result  has  been  a substantial  relief  and  abolition 
of  the  greatest  scourge  of  society.  It  was  the  medical  knowl- 
edge of  Howard  which  enabled  him  to  transform  the  prison, 
poorhouse,  and  asylum,  from  centres  of  pestilence — foci  of  con- 
tagion, dotting  civilized  lands — to  healthful  refuges  for  the 
vicious,  the  sick,  and  destitute.  It  was  the  science  as  well  as 
the  zeal  and  humanity  of  Pinel  which  reformed  the  treatment 
of  the  insane.  Hygiene  is  a monument  to  the  progress  of 
medicine. 

I have  alluded  to  the  influence  which  greater  personal 
culture  and  literary  talent  will  have  to  elevate  the  profession 
in  the  esteem  of  all  the  better  classes.  I believe  that,  with 
such  better  appreciation  of  our  body  by  our  clientage,  there 
will  arise  a closer  relation  between  us  ; that  the  doctor  of  the 
future  is  destined  to  become  the  adviser  and  guide  in  much 
that  pertains  to  safety  and  health,  rather  than  an  exclusive 
agency  of  necessity  in  sickness.  If  we  define  disease,  with 
Reynolds,  as  “any  condition  of  the  organism  which  limits 
life  in  either  its  powers,  enjoyment,  or  duration,”  surely  our 
field,  when  confidence  is  stronger,  will  be  broad.  Abernethy 
used  to  advise  his  patients  to  peruse  his  works,  as  well  as  to 
take  his,  medicine. 

Have  we  not  influence  to  avert  the  dangers  of  overwork, 
mental  and  physical;  to  dissuade  from  dissipation,  to  correct 
and  prescribe  the  diet  and  drink  that  shall  banish  dyspepsias  ; 
by  suggestions  and  admonitions  can  we  not  protect  our  client 
from  the  incipient  or  exciting  causes  of  phthisis?  We  may 
tell  the  public  of  sunlight,  of  ventilation,  and  exercise.  But, 
what  the  Sanitary  Board  is  to  the  public,  the  doctor  should 
be  to  the  individual.  It  will  be  for  him  to  say  what  are  the 
relations  of  mind  and  body,  when  shall  the  child  be  sent  to 
school,  what  educational  stress  will  his  individual  health,  his 
temperament  and  inherited  constitution  permit,  what  career 
is  he  warranted  in  undertaking. 

The  study  of  Nature,  sanitary  regulations,  and  regimen,  are 
sources  of  immunity  from  disease,  and  often  guide  us  in  our  arti- 
2 


IS 


ficial  means  of  cure.  But  hygiene  and  hygienics  can  never  sup- 
plant the  therapeutist ; it  will  ever  hold  true,  u Ars  medica  est 
id,  quod  est  propter  therapeuticen  ” — everything  in  medicine 
is  related  to  therapeutics.  Let  the  present  sources  of  infection 
and  contamination  he  swept  away,  annihilating  the  loathsome 
plagues — products  of  miasm  and  effluvia.  The  mind  will  still 
become  alienated,  the  brain  overtaxed,  the  lungs  inflamed,  the 
heart  enfeebled  with  age,  and  palpitating  and  faint  in  suffer- 
ing and  weakness  ; man  will  ever  look  to  the  physician,  to  one 
of  greater  knowledge  and  skill — not  only  as  his  counselor, 
guide,  and  friend,  but  chiefly  to  afford  an  earlier  and  more 
certain  deliverance,  or  hasten  the  processes  for  which  Nature 
points  the  way,  but  fails  to  accomplish  if  unaided.  There  is 
no  greater  fallacy  in  medicine  than  the  assertion,  “ When 
Nature  cannot  work,  the  effect  of  art  is  void.”  We  can  well 
say  of  our  art,  as  Laplace  of  science,  “ Our  knowledge  is 
trifling,  our  ignorance  immense ; ” yet  the  doctor  is  a positive 
agency  for  good.  Medicine  is  not  the  less  a science  because 
incomplete,  imperfect,  and  unsettled.  Is  astronomy  less  a 
science,  because  there  are  undiscovered  worlds  and  laws  unex- 
plained ? Is  mental  science  the  less  profound,  though  such  a 
veil  of  mystery  hangs  over  the  subtile  laws  of  mind.  If  we 
go  back  of  the  fifteenth  century,  before  the  brighter  periods  of 
medicine  which  Renaud  terms  the  “ age  of  renovation,”  even 
when  medicine  was  ruled  by  theories  and  dogmas — mated  with 
all  these  fallacies — wrere  solid  results,  discoveries,  truths  slowly 
established  but  cumulative. 

The  profession,  catholic  and  comprehensive  in  its  prin- 
ciples, year  by  year  discovers  some  new  truth  of  therapeutics, 
and  accepts  every  contribution  of  experience.  Does  the  world 
owe  nothing  of  its  progress  in  civilization,  its  present  safety, 
health,  and  happiness,  to  the  healing  art  ? Rome  is  said  to 
owe  her  decline  to  the  pestilences  that  devastated  her  armies, 
decimated  her  male  population,  and  left  her  a prey  to  the  bar- 
barians. Small-pox  was  a serious  obstacle  to  the  progress  of 
civilization  in  Europe.  During  one  hundred  years  previous 
to  the  discovery  of  vaccination,  forty  million  are  estimated  to 


19 


have  perished  by  its  ravages.  Do  our  merchants,  our  com- 
merce, proceeding  undisturbed  by  scurvy  and  cholera  and  yellow 
fever,  owe  nothing  to  medical  science  ? In  1740,  of  a thousand 
seamen  going  to  sea,  six  hundred  and  twenty-six  never  returned, 
destroyed  by  the  scurvy.  This  disease  crippled  the  marine  of 
every  nation.  Yet  by  a therapeutic  antidote — lemon-juice  and 
the  enforcement  of  partial  vegetable  diet  at  sea — it  quickly  dis- 
appeared ; and  in  1772  Captain  Cook  was  enabled  to  sail  round 
the  world  for  three  years,  with  but  a single  death.  The  cure 
of  disease  is  the  province  of  the  physician.  “ Felix  qui  potuit 
rerum  cognoseere  causas .”  But  more  important  in  daily  life 
than  theories  of  disease  or  knowledge  of  their  cause  is  the  cer- 
tain knowledge  of  their  means  of  cure.  Cullen  ascribed 
intermittent  fever  to  the  spasm  of  the  skin,  atfected  by  miasm  ; 
Broussais  to  mucous  phlegmasise  ; Brown  to  diffused  excita- 
bility of  the  whole  nervous  system  ; to  day  we  hold  to  a 
belief  in  the  cryptogamic  invasion  of  the  blood  ; but,  though 
we  cannot  discern  the  subtile  nature  of  the  disease,  we  can 
surely  cure,  by  quinine  and  its  analogues.  Our  recognition  of 
pyaemia  and  septicaemia,  the  whole  antiseptic  method  of  pro- 
phylaxis and  treatment,  our  certain  means  of  assuaging  pain, 
our  resources  for  shortening  and  resolving  disease — are  they 
not  such  as  to  afford  reason  for  our  therapeutic  faith,  a faith 
which  the  sincere  and  honest  physician  must  always  have? 
“ You  cannot  make  a fire  burn  well  if  you  put  the  wood  on 
the  andirons  with  a feeling  of  indifference.”  Says  Macaulay  : 
“ We  are  quite  sure  that  the  improvement  of  medicine  has  far 
more  than  kept  pace  with  the  increase  of  disease,  during  the 
last  three  centuries.  This  is  proved  by  the  best  possible  evi- 
dence. The  term  of  human  life  is  decidedly  longer  in  Eng- 
land than  in  any  former  age,  respecting  which  we  possess  any 
information  on  which  we  can  rely  ” (Southey’s  Colloquies, 1830). 
How  changed  the  mortality  of  great  cities  ! that  of  London  is 
said  to  be  50  per  cent,  less  than  it  was  two  hundred  years  ago, 
and  the  average  longevity  of  an  Englishman  is  increased  by 
several  years.  The  history  of  medicine  in  the  past  and  its 
rapid  advances  in  the  present  justify  us  in  designating  it  a 


3 0112  058795508 


20 

science,  imbued  with  the  spirit  of  progress ; and,  after  review- 
ing the  steady  and  permanent  contributions  to  its  therapeutic 
resources  in  every  age  and  country,  we  may  indeed  say  of  our 
art : 

“ Step  by  step,  since  time  began, 

I see  the  steady  gain  of  man, 

That  all  of  good  the  past  bath  had 
Remains,  to  make  our  own  time  glad.” 


